Appendix A: full search strategy

Database 1. infant/child/ adolescent

2. parent 3. Mental disorder

4. mental disorder categories 5. Physical illness

6. Disease categories 7. study type 8.combin-ation

9. restrictions

Number of hits

Medline exp infant/ or adolescent/ or child/ or child, preschool/ or "child of impaired parents"/ or (infant or new?born or girl$ or boy$ or child or adolescent$ or teen* or offspring).ti,ab,kw

father-child relations/ or fathers/ or maternal behavior/ or mother-child relations/ or mothers/ or parent-child relations/ or paternal behavior/ or parenting/ or parents/ or single parent/ or single-parent family/ or (father* or mother* or parent* or maternal or paternal).ti,ab,kw.

((mental adj3 disorder$) or (mental adj3 illness) or (psychiatric adj3 disorder$) or (psychiatric adj3 illness) or (mental adj3 health)).ti,ab,kw

exp mood disorders/ or substance-related disorders/ or alcohol-related disorders/ or amphetamine-related disorders/ or cocaine-related disorders/ or opioid-related disorders/ or exp psychotic disorders/ or exp "schizophrenia spectrum and other psychotic disorders"/ or exp Anxiety Disorders/ or exp Stress Disorders,

Traumatic/ or exp "Feeding and Eating Disorders"/ or (((affective or psychosocial or emotional or neurot*) adj2 disorder$) or neuros* or affective personality or depress* or ((substance or alcohol or drug) adj3 (misuse or abuse or dependence)) or addiction or psychotic or psychosis or schizo* or anxiety or phobi* or (obsessive adj3 disorder) or ocd or post?traumatic stress disorder or PTSD or ((eating adj3 disorder) or bulimia or anorexia)).ti,ab,kw

exp morbidity/ or (morbidity or (somatic adj3 disease) or (somatic adj3 illness) or (physical adj3 illness)).ti,ab,kw

"wounds and injuries"/ or allergy/ or arthritis/ or asthma/ or atopy/ or cancer/ or cardiovasular disease/ or congenital heart disease/ or diabetes/ or eczema/ or endocrine disease/ or epilepsy/ or gastroenteritis/ or gastrointestinal diseases/ or haematological disease/ or exp infection/ or meningitis/ or migraine/ or musculoskeletal diseases/ or obesity/ or rheumatic disease/ or (accidents or allerg* or arthritis or asthma or atopy or cancer or cardiovascular disease or congenital heart disease or diabetes or eczema or endocrine disorders or epilepsy or gastroenteritis or gastrointestinal diseases or haematological disorders or infect* or meningitis or migraine or musculoskeletal or obesity or rheumatological disorders or injury or "malignant neoplasms" or atopic dermatitus or "diarrhoea and vomiting" or rheumato*).ti,ab,kw

(Case-Control Studies/ or Control Groups/ or Matched-Pair Analysis/ or ((case* adj5 control*) or (case adj3 comparison*) or control group*).ti,ab.) or (cohort studies/ or longitudinal studies/ or follow-up studies/ or prospective studies/ or retrospective studies/ or cohort.ti,ab. or longitudinal.ti,ab. or prospective.ti,ab. or retrospective.ti,ab.) or epidemiological studies/ or Incidence/ or prevalence/ or (incidence or prevalence or (rate adj ratio) or (hazard adj ratio) or (relative adj risk) or (odds adj ratio)).ti,ab,kw.

1 and 2 and (3 or 4) and (5 or 6) and 7

limit 8 to (yr="1970 -Current")

6403

Ovid PsycINFO

exp infant development/ or child.mp. or exp parent child relations/ or (infant or new?born or girl$ or boy$ or child or adolescent$ or teen* or offspring).ti,ab,id

exp parents/ or exp father child relations/ or exp mother child relations/ or (father* or mother* or parent* or maternal or paternal).ti,ab,id.

((mental adj3 disorder$) or (mental adj3 illness) or (psychiatric adj3 disorder$) or (psychiatric adj3 illness) or (mental adj3 health)).ti,ab,id.

exp affective disorders/ or drug abuse/ or alcohol abuse/ or drug dependency/ or polydrug abuse/ or psychosis/ or Schizophrenia/ or exp anxiety disorders/ or Obsessive Compulsive Disorder/ or Posttraumatic Stress Disorder/ or exp Eating Disorders/ or (((affective or psychosocial or emotional or neurot*) adj2 disorder$) or neuros* or affective personality or depress* or ((substance or alcohol or drug) adj3 (misuse or abuse or dependence)) or addiction or psychotic or psychosis or schizo* or anxiety or phobi* or (obsessive adj3 disorder) or ocd or post?traumatic stress disorder or PTSD or ((eating adj3 disorder) or bulimia or anorexia)).ti,ab,id.

morbidity/ or epidemiology/ or exp physical disorders/ or (morbidity or (somatic adj3 disease) or (somatic adj3 illness) or (physical adj3 illness)).ti,ab,id.

exp accidents/ or exp allergic disorders/ or exp arthritis/ or exp rheumatoid arthritis/ or asthma/ or exp neoplasms/ or cardiovascular disorders/ or diabetes/ or exp eczema / or endocrine disorders/ or exp epilepsy/ or exp gastrointestinal disorders/ or "blood and lymphatic disorders"/ or infectious disorders/ or meningitis/ or migraine headache/ or exp musculoskeletal disorders/ or obesity/ or (accidents or allerg* or arthritis or asthma or atopy or cancer or cardiovascular disease or congenital heart disease or diabetes or eczema or endocrine disorders or epilepsy or gastroenteritis or gastrointestinal diseases or haematological disorders or infect* or meningitis or migraine or musculoskeletal or obesity or rheumatological disorders or injury or neoplasms or atopic dermatitus or "diarrhoea and vomiting" or rheumato*).ti,ab,id.

((case* adj5 control*) or (case adj3 comparison*) or case-comparison or control group*).ti,ab,id. or (cohort or longitudinal or prospective or retrospective or incidence or prevalence or (rate adj ratio) or (hazard adj ratio) or (relative adj risk) or (odds adj ratio)).ti,ab,id. or longitudinal study.md. or prospective study.md. or retrospective study.md. not "Literature Review".md.

1 and 2 and (3 or 4) and (5 or 6) and 7

limit 8 to (yr="1970 -Current")

2543

Ovid PsychARTICLES

(infant or new?born or girl$ or boy$ or child or adolescent$ or teen* or offspring)

(father* or mother* or parent* or maternal or paternal)

((mental adj3 disorder$) or (mental adj3 illness) or (psychiatric adj3 disorder$) or (psychiatric adj3 illness) or (mental adj3 health))

(((affective or psychosocial or emotional neurot*) adj2 disorder$) or neuros* or affective personality or depress* or ((substance or alcohol or drug) adj3 (misuse or abuse or dependence)) or addiction or psychotic or psychosis or schizo* or anxiety or phobi* or (obsessive adj3 disorder) or ocd or post?traumatic stress disorder or PTSD or (eating adj3 disorder) or bulimia or anorexia)

(morbidity or (somatic adj3 disease) or (somatic adj3 illness) or (psychical adj3 illness))

accidents or allerg* or arthritis or asthma or atopy or cancer or cardiovascular disease or congenital heart disease or diabetes or eczema or endocrine disorders or epilepsy or gastroenteritis or gastrointestinal diseases or haematological disorders or infect* or meningitis or migraine or musculoskeletal or obesity or rheumatological disorders or injury or neoplasms or atopic dermatitus or "diarrhoea and vomiting" or rheumato*

(case* adj5 control*) or (case adj3 comparison*) or case-comparison or control group* or cohort or longitudinal or prospective or retrospective or incidence or prevalence or (rate adj ratio) or (hazard adj ratio) or (relative adj risk) or (odds adj ratio) or (longitudinal adj study) or (prospective adj study) or (retrospective adj study)

1 and 2 and (3 or 4) and (5 or 6) and 7

limit 8 to (yr="1970 -Current")

5932

Ovid EMBASE

exp infant/ or adolescent/ or child/ or child, preschool/ or "child of impaired parents"/ or (infant or new?born or girl$ or boy$ or child or adolescent$ or teen* or offspring).ti,ab,kw

parent/ or father/ or mother or (father* or mother* or parent* or maternal or paternal).ti,ab,kw.

((mental adj3 disorder$) or (mental adj3 illness) or (psychiatric adj3 disorder$) or (psychiatric adj3 illness) or (mental adj3 health)).ti,ab,kw

exp mood disorder/ or drug dependence/ or alcoholism/ or substance abuse/ or drug abuse/ or addiction/ or exp psychosis/ or exp anxierty disorder/ or exp eating disorder/ or (((affective or psychosocial or emotional or neurot*) adj2 disorder$) or neuros* or affective personality or depress* or ((substance or alcohol or drug) adj3 (misuse or abuse or dependence)) or addiction or psychotic or psychosis or schizo* or anxiety or phobi* or (obsessive adj3 disorder) or ocd or post?traumatic stress disorder or PTSD or (eating adj3 disorder) or bulimia or anorexia).ti,ab,kw.

morbidity/ or epidemiology/ or (morbidity or (somatic adj3 disease) or (somatic adj3 illness) or (physical adj3 illness)).ti,ab,kw.

accident/ or injury/ or allergy/ or rheumatoid arthritis/ or arthritis/ or Asthma/ or atopy/ or malignant neoplasm/ or cardiovasular disease/ or congenital heart disease/ or diabetes mellitus/ or eczema/ or endocrine disease/ or epilepsy/ or gastroenteritis/ or gastrointestinal diseases/ or haematological disease/ or exp infection/ or meningitis/ or migraine/ or musculoskeletal disease/ or obesity/ or childhood obesity/ or rheumatic disease/ or (accidents or allerg* or arthritis or asthma or atopy or Cancer or cardiovascular disease or congenital heart disease or diabetes or eczema or endocrine disorders or epilepsy or gastroenteritis or gastrointestinal diseases or haematological disorders or infect* or meningitis or migraine or musculoskeletal or obesity or rheumatological disorders or injury or neoplasms or atopic dermatitus or "diarrhoea and vomiting" or rheumato*).ti,ab,kw.

exp case control Study/ or ((case* adj5 control*) or (case adj3 comparison*) or control group*).ti,ab. or (cohort analysis/ or cohort study/ or longitudinal studies/ or follow-up studies/ or prospective studies/ or retrospective studies/ or cohort.ti,ab. or longitudinal.ti,ab. or prospective.ti,ab. or retrospective.ti,ab.) or epidemiological studies/ or Incidence/ or prevalence/ or (incidence or prevalence or (rate adj ratio) or (hazard adj ratio) or (relative adj risk) or (odds adj ratio)).ti,ab,kw.

1 and 2 and (3 or 4) and (5 or 6) and 7

limit 8 to (yr="1970 -Current")

6251

Web of Science

(infant OR new?born OR girl$ OR boy$ OR child OR adolescent$ OR teen* OR offspring)

(father* OR mother* OR parent* or maternal or paternal)

((mental NEAR/3 disorder$) OR (mental NEAR/3 illness) OR (psychiatric NEAR/3 disorder$) OR (psychiatric NEAR/3 illness) OR (mental NEAR/3 health))

((affective or psychosocial or emotional or personality or neurot*) NEAR/2 disorder$) or neuros* or affective personality or depress* or ((substance or alcohol or drug) NEAR/3 (misuse or abuse or dependence)) or addiction or psychotic or psychosis or schizo* or anxiety or phobi* or (obsessive NEAR/3 disorder) or ocd or posttraumatic stress disorder or PTSD or (eating NEAR/3 disorder) or bulimia or anorexia

(morbidity OR (somatic NEAR/3 disease) OR (somatic NEAR/3 illness) OR (physical NEAR/3 illness))

(accidents OR allerg* OR arthritis OR asthma OR atopy OR Cancer OR cardiovascular disease OR congenital heart disease OR diabetes OR eczema OR endocrine disorders OR epilepsy OR gastroenteritis OR gastrointestinal diseases OR haematological disorders OR infect* OR meningitis OR migraine OR musculoskeletal OR obesity OR rheumatological disorders OR injury OR neoplasms OR atopic dermatitus OR "diarrhoea and vomiting" OR rheumato*)

(case* NEAR/2 control*) or (case NEAR/2 comparison*) or control group* or cohort or longitudinal or prospective or retrospective or incidence or prevalence or "rate ratio" or "hazard ratio" or "relative risk" or "odds ratio"

1 and 2 and (3 or 4) and (5 or 6)

- 3690

proquest ASSIA

infant OR newborn OR new-born OR girl* OR boy* OR child OR adolescent* OR teen* OR offspring

father* OR mother* OR parent* or maternal or paternal

((mental NEAR/3 disorder*) OR (mental NEAR/3 illness) OR (psychiatric NEAR/3 disorder*) OR (psychiatric NEAR/3 illness) OR (mental NEAR/3 health))

((affective or psychosocial or emotional or personality or neurot*) NEAR/2 disorder$) or neuros* or affective personality or depress* or ((substance or alcohol or drug) NEAR/3 (misuse or abuse or dependence)) or addiction or psychotic or psychosis or schizo* or anxiety or phobi* or (obsessive NEAR/3 disorder) or ocd or posttraumatic stress disorder or PTSD or

(morbidity OR (somatic NEAR/3 disease) OR (somatic NEAR/3 illness) OR (physical NEAR/3 illness))

(accidents OR allerg* OR arthritis OR asthma OR atopy OR Cancer OR cardiovascular disease OR congenital heart disease OR diabetes OR eczema OR endocrine disorders OR epilepsy OR gastroenteritis OR gastrointestinal diseases OR haematological disorders OR infect* OR meningitis OR migraine OR musculoskeletal OR obesity OR rheumatological disorders OR injury OR neoplasms OR atopic dermatitus OR "diarrhoea and vomiting" OR rheumato*)

(case* NEAR/2 control*) or (case NEAR/2 comparison*) or "control group" or cohort or longitudinal or prospective or retrospective or incidence or prevalence or "rate ratio" or "hazard ratio" or "relative risk" or "odds ratio"

1 and 2 and (3 or 4) and (5 or 6)

- 349

Appendix B: Fully summary of included studies

Study Design, setting, country and sample size

Exposure: Measures Outcome: Measures Effect measure/Analysis Unadjusted effect size (95% CI)

Adjusted effect size (95%CI)

Methods/Variables used for confounder control

Accidents/injuriesWilson 198134

Prospective maternity cohort, US N =125

Maternal substance misuse:Review of treatment and medical records, and urine sampling. Categorised into:1) heroin-dependent mothers; 2) methadone-treated mothers; and 3) drug-free mothers.

Accidents: Clinical assessment, including a physical and neurological examination.

OR drug-dependent vs. drug-free

1.90 (0.80 to 4.54) - Matched on maternal age, race, socio-economic level, marital status, gestational age

Howard 200336

Retrospective primary care matched cohort, UK, N=986

Maternal psychosis: Diagnosis of psychotic disorder or a prescription for a neuroleptic depot, an atypical antipsychotic drug or lithium.

Accidents: Self-referrals to accident and emergency departments, referrals to hospital out-patient departments, hospital admissions and primary care consultations.

RR 0.98 (0.55 to 1.74) - Matched on age and general practice

Phelan 200727

Prospective cohort of young mothers, US N=1,106

Maternal depression: Centre of Epidemiologic Studies Depression Scale (CES-D). <16 non-depressed; >16 for depressed.

Injuries: An injury requiring medical attention.

OR per unit increase in depression score

Not reported 1.04 (1.01 to 1.08) Adjusted for: family income, family size, maternal education, child race, child’s age and gender

Winqvist 200733

Retrospective cohort of population and hospital discharge registries, Finland N= 12,058

Maternal or paternal alcohol misuse: Hospital Discharge Register diagnosis of: alcoholic psychoses, alcohol dependence syndrome, alcohol abuse, alcoholic liver disease and alcoholic pancreatic disease.

Traumatic brain injuries: Clinical diagnosis of TBI from the Hospital Discharge Register.

RR 1.90 (1.13 to 3.17) 1.99 (1.19 to 3.33) Adjusted for: father's occupation, family background, place of residence, family history of alcohol misuse, child’s gender

McKinlay 201028

Prospective birth cohort, New Zealand, N= 1,265

Maternal depression: Levine-Pilowsky Depression Inventory. Continuous scale used.

Traumatic brain injuries: diagnosis at general practice or emergency department or hospital admission of a TBI or concussion. Excluding those who had an intentional injury.

HRLow depression scoreMedium depression scoreHigh depression score

REF1.22 (1.0 to 1.5)1.49 (1.0 to 2.3)

- None

Schwebel 201032

Prospective hospital birth cohort, US, N=584

Maternal and paternal depression: Centre for Epidemiological Studies Depression Scale. Continuous scale used.

Injury: Determined by mothers reporting their children’s history of injuries requiring professional medical attention at least once a year from grade 6 to 12.

OR per unit increase in depression scoreMaternal Paternal

1.00 (0.98 to 1.03)1.00 (0.97 to 1.03)

- None

Myhre 201229

Prospective pregnancy cohort, Norway, N=26,087

Maternal depression: Symptom Checklist SCL-8. Continuous scale used.

Injury: Self-reporting of a clinical event.

OR high mental distress vs. low

1.12 (1.06 to 1.18) 1.09 (1.03 to 1.16) Adjusted for: older siblings, maternal age, maternal education, employment, child not living with father, financial problems, child’s gender, gestational age, motor/ social/ communication development, temperament, externalising behaviours.

Orton 201230

Nested case-control study, primary care records, UK, N=104,512

Maternal depression: Clinical diagnosis

Injuries: thermal, fractures, poisonings: Clinical diagnosis of thermal injury, fracture or poisoning

ORThermal injuriesFracturesPoisoning

1.22 (1.08 to 1.39)1.06 (0,93 to 1.20)1.50 (1.29 to 1.75)

1.15 (1.02 to 1.32)Not reported p > 0.051.45 (1.24 to 1.70)

Matched on general practice. Adjusted for: child’s gender, age at injury, birth order, maternal age at birth, household composition, harmful alcohol consumption, area-level deprivation

Baker 201631

Retrospective cohort primary care records, UK, N= 54,702

Maternal depression or anxiety: Child was considered exposed for six months from the point when there was diagnostic, symptom, hospital, or treatment record for depression/anxiety. The episode was considered to have ended if there were no further recordings within the subsequent 6 months, after which the child was

Injuries by: poisoning, fractures, burns or serious injuries: Clinical diagnosis of incident poisonings, fractures, and burns from primary care or hospital record

RR (time-varying exposure)Poisonings: Depression AnxietyAnxiety and depression

FracturesDepression AnxietyAnxiety and depression

1.62 (1.39 to 1.88) 1.65 (1.11 to 2.47) 2.43 (2.03 to 2.90)

1.18 (1.05 to 1.32) 0.90 (0.64 to 1.28) 1.28 (1.10 to 1.49)

1.52 (1.31 to 1.76) 1.63 (1.09 to 2.43) 2.30 (1.93 to 2.75)

1.15 (1.03 to 1.28)0.87 (0.61 to 1.23) 1.24 (1.06 to 1.44)

Adjusted for: area level deprivation, calendar year and region

Appendix C: quality assessment of included studies

Criteria*Study Study design 1 2 3 4 5 6 7 8 9 10 11 12 13** 14** Grade

Wilson 1981 cohort no yes yes NR no yes yes yes no yes no yes yes No poor

Howard 2003 case controlyes yes yes yes yes yes NR yes yes yes yes yes good

Phelan 2007 cohortyes yes yes no no yes yes yes yes no yes yes no yes fair

Winqvist 2007 cohortyes yes yes yes no no no no

NA no no yes NR yes poor

McKinlay 2010 cohortyes yes yes yes no CD no yes yes yes yes yes yes yes poor

Schwebel 2010 cohortyes yes no yes no yes yes yes yes no no yes no yes poor

Myhre 2012 cohortyes yes no yes no yes yes yes yes no no yes no yes poor

Orton 2012 cohortyes yes yes yes yes CD yes yes yes no no yes yes yes fair

Baker 2016 cohortyes yes yes yes yes yes yes yes yes yes yes yes yes yes good

Raitasalo 2017 case controlyes yes no yes yes yes yes no yes yes yes yes good

Klinnert 2001 cohortyes no NR no no yes yes yes yes no no no no yes poor

Kozyrskyj 2008 cohortyes yes yes yes no yes yes yes yes yes yes yes no yes fair

Cookson 2009 cohortyes yes yes yes no yes yes yes yes yes yes yes no yes fair

Lange 2010 cohortyes yes yes yes no CD CD no no no yes NR no yes poor

Giallo 2015 cohortyes yes yes yes no yes yes yes yes yes yes yes no yes fair

Kozyrskyj 2017 cohortyes yes yes yes no yes yes yes yes yes yes yes no yes fair

Magnus 2017 cohortyes yes no yes no yes yes yes yes yes yes yes no yes fair

Brew 2018 cohortyes yes yes yes no no no yes yes yes yes yes yes yes fair

Wang 2016 cohortyes yes no yes no yes yes yes yes no yes NA yes yes good

Letourneau 2017 cohortyes yes no yes no yes yes yes yes yes no NA no no fair

Elbert 2017 cohortyes yes yes yes no yes yes yes yes yes yes yes no yes fair

Bronte-Tinkew 2007 cohortyes yes NR NR no yes yes no yes no yes NR yes yes fair

De Sousa 2009 case control no yes no NR yes yes NR NR no yes NR no poor

Ajslev 2010 cohortyes yes no yes no yes yes yes yes no no yes no yes fair

Santos 2010 cohortyes yes yes yes no yes yes yes yes yes yes NR yes yes good

* Studies graded according to criteria for cohort or case-control studies https://www.nhlbi.nih.gov/health-topics/study-quality-assessment-tools **criterion for cohort study onlyNR: Not reported; CD: Cannot determine; NA: Not Applicable;

Appendix D: sensitivity analysis showing forest plot after removal of studies ranked poor quality

Appendix E: subgroup analysis showing forest plot of case-control and cohort studies